Provider Demographics
NPI:1609905439
Name:SOSINSKY, MARISA LAURA (MD)
Entity type:Individual
Prefix:DR
First Name:MARISA
Middle Name:LAURA
Last Name:SOSINSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9746 N 90TH PL
Mailing Address - Street 2:#203
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5083
Mailing Address - Country:US
Mailing Address - Phone:480-614-0707
Mailing Address - Fax:480-614-0353
Practice Address - Street 1:9590 E IRONWOOD SQUARE DR STE 125
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4583
Practice Address - Country:US
Practice Address - Phone:480-455-3000
Practice Address - Fax:866-819-6115
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ339482084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ7807693OtherAETNA ID #
AZ8730050OtherCIGNA ID #
AZ2Z2392OtherHEALTHNET ID #
AZ86-0436212OtherGROUP TIN #
AZ2538403OtherUNITEDHEALTHCARE ID #
AZZWCKFMOtherMEDICARE GROUP ID #
AZAZ0306840OtherBCBS ID #
AZBS9375836OtherDEA #
AZAZ0306840OtherBCBS ID #
AZ8730050OtherCIGNA ID #